Whether you plan to have children or not, a woman’s fertility is essential to the survival of the human species. And yet, many people know less than they should about the realities of conception and what it takes to preserve fertility. Research published in the journal Fertility and Sterility found that while 40 percent of the 1,000 participating women, between ages 18 and 40 in the United States, expressed concerns about their ability to conceive, one-third of them were unaware of adverse effects that sexually transmitted infections (STDs), obesity, or irregular periods could have on their ability to procreate, and 40 percent were unfamiliar with the ovulatory phase. (1)
Commonly Misunderstood Concepts About Reproduction: Fertilization, Conception, and Pregnancy
“It is still very common for women to have basic misunderstandings about fertility in terms of pregnancy/family planning,” says Toni Weschler, MPH, the author of Taking Charge of Your Fertility and Cycle Savvy. “One of the most prevalent myths about fertility is that ovulation always occurs on day 14. If this were true, there would be virtually no need for birth control, since couples could simply avoid intercourse around that one day. And scores of couples desiring to conceive would simply have intercourse on day 14, and bingo! — the woman would get pregnant.”
RELATED: Getting Pregnant, Fertility, and Infertility: Need to Know Info for Women and Men Under Age 35
Menstrual Cycle Math, and Timing of Ovulation, Varies by Woman
The truth is, the timing of ovulation can vary from one woman to another, even from one cycle to the next in the same woman. But that doesn’t mean that a woman can spontaneously ovulate at any time in the cycle, as some people believe, Weschler says. “Once a woman ovulates [in a particular menstrual cycle], there are usually about two weeks before her next cycle starts with a period and it is not possible for her to ovulate again until the following cycle.”
The Window of Fertility Occurs Once Per Menstrual Cycle in Fertile Women
The reason: Once ovulation occurs, the hormone progesterone is secreted in the second half of the menstrual cycle, and progesterone suppresses the release of other eggs until the following cycle, Weschler says. Meanwhile, women are fertile for only a few days around ovulation, which is another thing many women don’t fully understand, so once that baby-making window has closed, it remains shut until she next ovulates.
To Get Pregnant, It’s Important to Understand and Recognize When to Have Sex
Indeed, a 2017 survey of nearly 2,100 women in the U.S. and Europe revealed that 49 percent of the U.S. women said they didn’t understand the importance of timing sexual intercourse around the fertile days of the menstrual cycle.
Related: Some Fertility Apps Help Women Identify Fertility Window, Study Says
What’s more, 83 percent of the U.S. women said they underestimated the amount of time it would take them to get pregnant, and 72 percent admitted they had inconvenient or unromantic sex in order to try to conceive. (2)
Learn More About Healthy Sex: The Ultimate Guide
Age, Age, Age: A Woman’s Fertility Depends on How Old She Is
Many people also don’t realize the extent to which age can affect a woman’s fertility. In research published in Human Reproduction, researchers interviewed 61 women who delivered their first child after age 40 through in vitro fertilization (IVF). They found that 30 percent of the women expected their fertility to decline gradually until menopause, around age 50, and 31 percent said they expected to get pregnant without difficulty at age 40; what’s more, 44 percent said they were “shocked” and “alarmed” to discover that their understanding of the time-frame for age-related reproductive decline was inaccurate. (3)
Learn More About What Men and Women 35 and Older Must Know About Fertility, Infertility and Getting Pregnant
As Chronological Age Increases, Fertility Declines
The reality is: “Age delivers the harshest blow to fertility, causing a mild decline at age 35, a precipitous drop at age 38, and another whopping one at 40,” notes Joseph A. Hill, MD, a reproductive endocrinologist and infertility specialist, and the president of the Fertility Centers of New England in Boston. During these time spans, the majority of a woman’s chromosomally competent eggs disappear. A female is born with all the eggs she will ever have — approximately 1 to 2 million — and the number declines to 300,000 to 500,000 at puberty, according to the American College of Obstetricians and Gynecologists. (4) After that, fertility continues to drop, hitting a dramatic slide in a woman’s late thirties.
Related: What to Say (and NOT to Say) to Someone Living With Infertility
Other Sneaky Fertility Foilers for Women
Meanwhile, sexually transmitted infections such as chlamydia and gonorrhea can damage a woman’s fertility. (5)
Learn More About STDs: What They Are and Who Gets Them
Smoking and Other Factors That Contribute to Miscarriage Risk
Another major fertility spoiler is smoking, which is toxic to eggs and embryos and increases the risk of miscarriage, Dr. Hill says.
Learn More About Miscarriage and Pregnancy Loss
Learn More About Celebrities Who Spoke Out About Miscarriage
Body Weight and Body Mass Index (BMI) May Influence Fertility Status
Being significantly overweight or underweight also can decrease a woman’s chance of getting pregnant by disrupting her proper balance of hormone levels; so can excessive exercise or athletic training and heavy alcohol use. (6)
Learn More About How Body Weight and Body Mass Index (BMI) Affects a Woman’s Fertility and Ability to Conceive
Learn More About the Ketogenic Diet and Fertility
IVF Basics: What To Know About Undergoing Fertility Testing and Treatments
When you’re having trouble getting pregnant, going to a fertility clinic can be an overwhelming experience. Besides being stressful in its own right, infertility comes with a whole vocabulary that may sound foreign to you. It helps to read about the journey before you go through it: tests, drugs, or treatments that may be recommended for you, depending on the suspected root cause of your problem.
Learn more about Essential Facts About In Vitro Fertilization and Other Fertility Treatments
Questions To Ask Yourself, Your Partner, and Your Doctor
It’s easier said than done, but it is important to keep an open mind, manage stress, and manage expections.
Learn more about 8 Things Your Doctor Won’t Tell You About In Vitro Fertilization and Fertility Treatments
Related Conditions
Fertility Myths and Misconceptions to Avoid
Unfortunately, because a woman is born with all the eggs she will ever have, “even if a woman eats well, exercises, and is a healthy weight, her eggs will still be as old as her chronological age,” Weschler says. “This reality can be incredibly frustrating and more than a tad inequitable when it comes female fertility. So there really is a biological reason why women should try to have children before 40, and realistically even earlier, if possible.”
Learn More About Celebs Who May Have Fueled Fertility Myths
Medical Conditions and Disease Symptoms May Compromise Fertility
In addition, underlying medical conditions such as poorly controlled diabetes, certain thyroid disorders, and celiac disease can compromise a woman’s fertility, notes Mary Ellen Pavone, MD, an associate professor of obstetrics and gynecology in the division of reproductive endocrinology and infertility at the Northwestern University Feinberg School of Medicine in Chicago. The same is true of endometriosis and polycystic ovary syndrome (PCOS). (5,6)
Related: What Is Silent Endometriosis?
Foretelling the Future of Your Health: Is Fertility a Sixth Vital Sign?
The association between a person’s reproductive health and future overall health is now considered so strong that research published in May in 2017 in Human Reproduction Open suggests that fertility status could be considered as the sixth vital sign. Based on a workshop featuring 40 experts from around the world, the report addresses the question of whether a person’s fertility can tell her or him anything about how healthy she or he will be in the future. More research needs to be done before a definitive answer can be made. (7)
But already associations have been found between reproductive variables in women such as premature egg loss, primary ovarian insufficiency, or early menopause and her risk of developing cardiovascular disease. Strong links also have been found between anovulation (including that related to PCOS) and an increased risk for uterine cancer, between PCOS and an increased risk of diabetes and cardiovascular disease, and between endometriosis and an elevated risk for ovarian cancer. (7)
Related: The Question of Which to Treat First: Endometriosis or Fertility Problems?
The take-home message: Even if you choose not to have children, it’s important to pay attention to your fertility status because it could give you valuable clues to your future health risk — risks that you could take steps to reduce or mitigate.
Silent Endometriosis, Explained
Silent endometriosis occurs when a woman doesn’t show symptoms; many discover it when they have infertility
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Fertility and Fertility Awareness Resources We Love
Figuring out your fertility status, as well as how to safeguard and maximize your fertility, can be a confusing proposition. These resources can help make it easier.
Favorite Sites for Must-Know Fertility Info
American College of Obstetricians and Gynecologists (ACOG) www.acog.org
ACOG is a go-to source for research-supported fertility, conception, pregnancy, and women’s health news and best practices. In fact, Everyday Health writers and editors make a point to attend ACOG’s annual meeting to learn about the latest breakthroughs in these areas. We also love that ACOG’s website has a special section just for patients that’s packed with FAQs, infographics, and more.
ReproductiveFacts.org www.reproductivefacts.org
ReproductiveFacts.org is the patient-centered arm of the American Society for Reproductive Medicine. This well-respected one-stop shop for all thing fertility offers concise and thorough brochures and booklets on assisted reproductive technology, the Zika virus, sexual dysfunction, and other key reproductive health issues. It’s also a great resource for the latest in fertility news and research breakthroughs.
Office on Women’s Health (OWH) www.womenshealth.gov
OWH is part of the U.S. Department of Health and Human Services (HHS) and its website is packed with the most up-to-date facts on such topics as the weight and fertility connection, male infertility, and more. Our favorite feature is the OWH Helpline (800-994-9662) where you’ll get even more specialized info on fertility.
Favorite Sites for Support
The Seleni Institute seleni.squarespace.com
Seleni is a global nonprofit dedicated to supporting the emotional health of women and their loved ones during the family-building years. The site offers a plethora of mental health advice and insights on infertility and miscarriage from experts and from fellow women who’ve been through it. Bonus: A printable Infertility Etiquette 101 sheet you can hand out to friends and family.
Resolve: The National Infertility Association www.resolve.org
Resolve is a national patient advocacy organization that provides free support services in more than 200 communities. The organization can not only point you to in-person support but also offers a help line (866-NOT-ALONE) where you can connect with exactly the trained volunteer you need. For instance, if you’ve been newly diagnosed with infertility, you’re advised to press 1; dealing with male factor infertility, press 5; secondary infertility, press 8.
Favorite Sites for Miscarriage Info
The Reproductive Health Access Project www.reproductiveaccess.org
This organization offers comprehensive fact sheets about miscarriage and its treatment options, along with related subjects. They also spearhead the Miscarriage Care Initiative, which works to expand access to evidence-based, patient-centered miscarriage care in a primary care settings.
@ihadamiscarriage www.instagram.com/ihadamiscarriage
In 2015, Jessica Zucker, PhD, a clinical psychologist who specializes in reproductive and maternal mental health, launched her Instagram account in order to highlight how common pregnancy loss is — and to offer a community of support. Today, it has more than 35,000 followers.
Favorite Site for Finding a Fertility Specialist
Society for Assisted Reproductive Technology www.sart.org
On SART’s website you can find fertility clinics by ZIP code, state, or region — and you can locate each clinic’s latest success rate statistics by clicking “Success Rates and Clinic Details.” The SART site also features a quiz to help determine if IVF treatment will be successful for you.
